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ACEP State Public Policy Grant Program

Overview

To assist chapters in pursuing extraordinary state public policy initiatives that are aligned with ACEP’s national priorities, ACEP has established a budgeted state public policy grant program. This program awards $6,250 per grant recipient, with annual allocations not exceeding $50,000, or 8 grant recipients, per year. Grants are awarded to chapters that meet strict criteria and demonstrate a significant commitment to pursuing an exceptional effort to enact state policy changes that are highly meaningful to emergency medicine.

The maximum amount of grant funds available for any single state public policy initiative can not exceed one-fourth of the total amount budgeted for this program in that fiscal year. To qualify for this program, chapters must commit their own funds and/or other resources, amounting to a dollar-for-dollar match of the funds being requested from ACEP, as described in the criteria below. 

In addition to supporting extraordinary public policy efforts initiated by state chapters, this program may also be utilized by ACEP to initiate and support exceptional multi-chapter efforts to pursue significant public policy initiatives identified by the Board of Directors. 

Summaries of Previously Accepted Applications

Example 1: Connecticut

The state of Connecticut recently passed SB-181 which requires hospital emergency departments to report boarding data to the state legislature and is the first state to pass such a bill. Specifically, the bill requires all emergency departments to report the percentage of patients admitted to the hospital but transferred to a location other than the ED more than four hours after an admission order was placed (boarding). Additional required information includes overall number of patients treated, number admitted, and the average length of stay in the ED for admitted patients.

With funding from ACEP’s State Public Policy Grant, the Connecticut College of Emergency Physicians will bring transparency to the public on the boarding crisis by developing initiatives to increase access to state-level data on emergency department boarding metrics. More specifically, the chapter will create a website that features interactive data visualizations, use software to ensure accurate and timely data collection from the state legislature, execute a public engagement and awareness campaign via digital media, and monitor the overall impact of the project and compliance with state requirements. This data collection and sharing will enhance efforts to increase transparency,
inform public policy, and help drive the systemic solutions necessary to
meaningfully address the crisis of boarding in EDs.

 

Example 2: Colorado

In Colorado, med mail insurers, property and casualty insurers, and the state medical society formed the Coloradans Protecting Patient Access (CPPA) Coalition. Colorado Chapter of Emergency Physicians was able to join the Coalition in a voting capacity and met the contribution threshold thanks to funds provided from ACEP’s State Public Policy Grant. As a member of CPAA Coalition, Colorado College of Emergency Physicians helped steer the negotiations on caps and peer review.  Through this grant, Colorado College of Emergency Physicians was able to have the voice of EM head in coming to a resolution, and had the inside story to explain the caps increases to Chapter members.

As a member of CPPA Coalition, Colorado College of Emergency Physicians was able strategize with government officials and have their ideas incorporated into HB24-1472, which was passed  unanimously through both chambers on the final day and signed by the governor. From this bill, a moratorium on caps increases and attacks on the confidentiality of peer review proceedings was put into place.

Example 3: Pennsylvania

The Pennsylvania College of Emergency Physicians is a two-time grant funding recipient. The chapter is in the process of developing a collaborative network of emergency departments across the Commonwealth including all types of EDs that will collect ongoing data repository on the ED experience of pediatric mental health patients. The data will include numbers of children, gender, ages, duration of boarding, and zip codes of patients.

With this data collection, the Collaborative network will be able to measure and assess how the behavioral health system for children and youth is functioning. The network will also educate ED physicians and nurses about potential solutions to ED boarding. Grant funding from ACEP’s State Public Policy Grant Program will support personnel training and weekly reporting to the network, maintenance of the reporting database, generation of ongoing boarding metrics of pediatric mental health patients, and measurement of intervention impacts.

Example 4: Virginia

Virginia College of Emergency Physicians (VACEP), along with the Medical Society of Virginia (MSV) and Dr. Todd Parker, sued the Department of Medical Assistance Services (DMAS). In 2020, DMAS imposed the Virginia Statutory Downcoding Provision by which it reduced the amount it paid under Medicaid to emergency medical providers if it was determined that the claim was preventable. This was overturned in April of 2023 by the US District Court because it was deemed a violation of federal law. VACEP, MSV, and Virginia Hospital and Healthcare Association sent a letter to DMAS seeking reimbursement for claims between July 1, 2020, and April 27, 2023. The Virginia Attorney General replied, “no such retroactive relief is available.” DMAS also sent a letter that it had “no legal authority to pay retroactive claims.”

VACEP, along with MSV and Todd Parker, engaged Nathan Kottkamp and the law firm of Williams Mullen to appeal this decision. The state submitted a Plea in Bar and Demurrer, essentially throwing the kitchen sink at us to get the case dismissed on procedural issues (jurisdiction, sovereign immunity, etc.). Their "strongest" argument was that we never had a formal "appeal" and the Director's letter to us did not constitute a "case decision" as required by the APA. We disagreed, saying we asked for an appeal opportunity and her letter clearly denied that. Unfortunately, the judge agreed with the state that the letter did not constitute a formal case decision on an appeal, and all the other arguments were dismissed.

Currently VACEP has paid $51,722 in legal fees. ACEP’s grant of $6,250 went to help offset this cost.

Procedures

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Chapter applications will be considered on a first-come, first-served basis in each fiscal year. If all budgeted funds are allocated at any point during the fiscal year, no additional grant requests can be approved during that fiscal year.

In the event the ACEP Board of Directors authorizes funding from this program to support an exceptional multi-state effort identified by the Board, ACEP will establish criteria and guidelines specific to the project and distribute funds to relevant state chapters to support the identified effort, pursuant to the chapters’ agreement to utilize the funds in the manner prescribed by the Board. 

Criteria

  • Grants will only be awarded for state public policy efforts that are aligned with a national ACEP priority objective.
  • Grants will only be awarded for extraordinary public policy efforts undertaken by a chapter that exceed the scope of typical advocacy activities (such as lobbying, PAC fundraising, support for state candidates, etc.) and that would significantly enhance the emergency medicine environment in the state or advance a national ACEP public policy objective/initiative.
  • Grants will only be awarded to those chapters that demonstrate a significant chapter and member commitment to the public policy effort.  This commitment must include at least a dollar-for-dollar match of chapter funds to the grant amount being sought from ACEP, or the chapter may provide a substantial amount of in-kind services to support the project.  The estimated value of these in-kind services (which may include staff and volunteer time specifically dedicated to the grant project, as well as other project-related materials and services) should reasonably correspond with the amount of unmatched grant funds requested from ACEP.  
  • Individual chapter grants may not exceed one-fourth of the total amount budgeted for this program in any fiscal year. Grants may be awarded to the same chapter for the same project in subsequent years, but only if the chapter can demonstrate that progress was made on the project as a result of the previous grant and that there is a reasonable chance that a subsequent grant could result in the successful completion and fulfillment of the original goals of the project.
  • Chapters must demonstrate that grants from ACEP would have no taxable impact on ACEP and would comply with all applicable legal requirements.
  • Grants cannot be provided to chapter PACs. 
  • Chapters seeking grants must submit a request in writing outlining the project and detailing how the request meets all the criteria established in this program. Chapters may use the State Public Policy Grant Application form in preparing their submission.
  • Grant requests must include:
    • a detailed breakdown of how grant funds would be spent.
    • a description of the public policy effort, including strategies, tactics, allies, adversaries, and the political climate as it applies to the possible success of the effort.
    • information on other organizations (if any) involved in the advocacy effort and the level of commitment provided by those organizations.
  • Successful grant awardees are expected to provide the State Legislative/Regulatory Committee with updates at least every six months on the progress of their project.  At the completion of the project, awardees should provide a brief written summary of their grant project detailing results and any lessons learned, supply a copy of all work product related to the project, and summarize their project in a presentation to the State Legislative/Regulatory Committee at its meeting during Scientific Assembly or the Leadership and Advocacy Conference.

ACEP State Public Policy Grant Application

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